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Prognostic value of jaundice in patients with gallbladder cancer by the AFC-GBC-2009 study group.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2011 Jun; Vol. 37 (6), pp. 505-12. Date of Electronic Publication: 2011 Apr 21. - Publication Year :
- 2011
-
Abstract
- Introduction: Jaundice is frequent in patients with gallbladder cancer (GBC) and indicates advanced disease and, according to some teams, precludes routine operative exploration. The present study was designed to re-assess the prognostic value of jaundice in patients with GBC.<br />Methods: Patients with GBC operated from 1998 to 2008 were included in a retrospective multicenter study (AFC). The main outcome measured was the prognostic value of jaundice in patients with GBC focusing on morbidity, mortality and survival.<br />Results: A total of 110 of 429 patients with GBC presented with jaundice, with a median age of 66 years (range: 31-88). The resectability rate was 45% (n=50) and the postoperative mortality and morbidity rates were 16% and 62%, respectively; 71% had R0 resection and 46% had lymph node involvement. Overall 1- and 3-year survivals of the 110 jaundiced patients were 41% and 15%, respectively. For the 50 resected patients, 1- and 3-year survivals were 48% and 19%, respectively (real 5-year survivors n=4) which were significantly higher than that of the 60 non-resected patients (31%, 0%, p=0.001). Among the resected jaundiced patients, T-stage, N and M status were found to have a significant impact on survival. R0 resection did not increase the overall survival in all resected patients, but R0 increased median survival in the subgroup of N0 patients (20 months versus 6 months, p=0.01).<br />Conclusion: This series confirms that jaundice is a poor prognostic factor. However, the presence of jaundice does not preclude resection, especially in highly selected patients (N0).<br /> (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Common Bile Duct surgery
Contraindications
Female
Humans
Lymph Node Excision
Male
Middle Aged
Portal Vein surgery
Predictive Value of Tests
Prognosis
Research Design
Retrospective Studies
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
Vena Cava, Inferior surgery
Cholecystectomy methods
Gallbladder Neoplasms complications
Gallbladder Neoplasms surgery
Jaundice etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 37
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21514090
- Full Text :
- https://doi.org/10.1016/j.ejso.2011.03.135